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Jun 15 2015

General Compensability Ruling

Mendoza Sanchez v. Enterprise Rent-A-Car (BPD) (2014 Cal. Wrk. Comp. P.D. LEXIS 596):

 

Applicant filed a request for an expedited hearing.

 

Defendant admitted injury to applicant’s orthopedic conditions but denied injury in the forms of hypertension and diabetes/Kidney Injury.

 

Applicant filed for an expedited hearing on the issue of medical treatment for Kidney Injury/diabetes.

 

Following an expedited hearing the WCJ found the applicant suffered compensable injuries in the forms of hypertension and diabetes and was entitled to medical treatment for resulting kidney injury.

 

Defendants filed a petition for reconsideration.

 

The WCAB found that the WCJ did not err in deciding compensability of applicant’s diabetic condition and hypertension and expedited hearing. Pursuant to Labor Code § 5502 (b) (1) and regulation § 10252 (a) (1) and (b), issues of entitlement to medical treatment for disputed body parts were appropriate for expedited hearing.

 

The WCAB stated that compensability of disputed body parts was inherent in deciding medical treatment issue. That there was no requests for authorization (RFA) for medical treatment did not preclude WCJ from deciding issue, as labor Code § 5502 (b) (1) expressly authorizes WCJ to determine injured employee’s entitlement to medical treatment pursuant to Labor Code § 4600.

 

The board went on to indicate that specific treatment issues must be determined through the UR process pursuant to Labor Code §§ 4610 and 4610.5.

 

In this case the board went on to state the WCJ made a general finding as to medical treatment for the kidneys/hypertension and did not make any award subject that would require an RFA.

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